title: Functional outcome assessment after open tennis elbow release: what are the predictor parameters?
abstract: BACKGROUND
  Open surgical release remains the gold standard for treatment of recalcitrant lateral epicondylitis (tennis elbow). We aimed to evaluate the potential impact of perioperative factors on outcome after open surgical release for tennis elbow.
  
  
  METHODS
  All patients without elbow dislocation who underwent open surgical release for tennis elbow from January 2000 to June 2006 were included in the study. Comorbidities and associated pathologies of the upper limb as well as postoperative pain score, range of motion, evidence of instability, recurrence and other complications were noted.
  
  
  RESULTS
  There were 37 female and 24 male patients aged 22-60 (44.95 +/- 7.34) years. Five (8.1 percent) patients had diabetes mellitus. The mean duration of symptoms before surgery was 16.8 +/- 15.3 (range 2-84) months. The average duration of follow-up was 23.0 +/- 34.5 (range 0.4-206) months. Overall, 59 (96.7 percent) patients reported improvement of symptoms post surgery. Median grip strength on the operated and unoperated sides were 25.5 +/- 9.0 (range 10.5-44.0) KgN and 23.7 +/- 9.1 (range 9.3-41.5) KgN, respectively. Patients with diabetes mellitus had significantly higher pain scores (2.80 versus 0.36, p-value less than 0.01, 95 percent confidence interval [CI] 1.2-3.7), reduced grip strength (0.91 KgN versus 1.06 KgN, p-value is 0.038, 95 percent CI 0.29-0.01) and higher recurrence rates (40 percent versus 7.7 percent, p-value is 0.018).
  
  
  CONCLUSIONS
  Diabetes mellitus has a negative effect on surgical outcome in terms of pain scores, grip strength ratio and recurrence rate. This should be reiterated during preoperative counselling.
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Outram Road, Singapore 169608. mmashfiqul@yahoo.co.uk
authors.forename: M A
authors.initials: MA
authors.lastname: Siddiqui
authors.forename: J
authors.initials: J
authors.lastname: Koh
authors.forename: J
authors.initials: J
authors.lastname: Kua
authors.forename: T
authors.initials: T
authors.lastname: Cheung
authors.forename: P
authors.initials: P
authors.lastname: Chang
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012189:Retrospective Studies; D013710:Tendons / Q000503:physiopathology / Q000601:surgery*; D013716:Tennis Elbow / Q000503:physiopathology* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult